tag:blogger.com,1999:blog-18943510.post8701135744104342236..comments2016-12-09T05:16:20.988-06:00Comments on Dr. Wes: EKG DU Jour #19: A Case of ObtundationDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-18943510.post-10864697924508247832011-12-21T13:09:04.581-06:002011-12-21T13:09:04.581-06:00thermodynamics and heat transfer.
as long as the ...thermodynamics and heat transfer.<br /><br />as long as the room is colder than the combination of (a) his body temperature, (b) his body&#39;s ability to generate heat, and (c) his clothing&#39;s ability to prevent heat loss, his body temperature and the ambient temperature will always reach equilibrium. especially when given enough time.burned-out medichttp://burnedoutmedic.comnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-87602038157290107522010-01-24T13:58:32.555-06:002010-01-24T13:58:32.555-06:00Nice case. One comment though: it&#39;s not a PAC....Nice case. One comment though: it&#39;s not a PAC. The P wave morphology is exactly the same, and the coupling interval of the &quot;PAC&quot; is exactly half of the normal P-P interval. This suggests 2:1 sinoatrial block with occasional 1:1 conduction.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-30256176825923966392009-12-02T17:32:18.727-06:002009-12-02T17:32:18.727-06:00How did the patient get so cold?How did the patient get so cold?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-67780329966179581872009-11-30T21:40:16.043-06:002009-11-30T21:40:16.043-06:00I did undergrad and med school in Rochester, NY. G...I did undergrad and med school in Rochester, NY. Gotta know the J wave. The only thing missing was tremor artifact (aka pseudo flutter). :-)Michael Katzhttp://twitter.com/MGKatz036noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-9930316266486319672009-11-30T21:07:11.247-06:002009-11-30T21:07:11.247-06:00Yeah. I saw the osborne wave (tiny in this case) b...Yeah. I saw the osborne wave (tiny in this case) but i figured it was. <br /><br />1). Not that easy<br />2). The patient was in doors<br /><br />I once had a patient with unbelievable classic Osborne waves. You never forget themThe Happy Hospitalisthttp://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-70165142984121304932009-11-30T19:04:54.893-06:002009-11-30T19:04:54.893-06:00Thanks to all who gave it a shot, but Michael Katz...Thanks to all who gave it a shot, but Michael Katz saw the finding. (I have recently updated the EKG so it can be seen better when enlarged.)<br /><br />The question asked was &quot;What&#39;s the patient&#39;s core body temperature?&quot;<br /><br />When measured, the patient&#39;s temperature was 33.2 degrees Celcius (92.1 degrees Farenheit). The EKG shows sinus bradycardia with an occasionalDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-70955573905169513932009-11-30T18:08:46.063-06:002009-11-30T18:08:46.063-06:00How long was pt down? Body temp? Is there a J wave...How long was pt down? Body temp? Is there a J wave in V4-V5?Michael Katzhttp://twitter.com/MGKatz036noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-62142036907276098822009-11-30T17:50:34.764-06:002009-11-30T17:50:34.764-06:00What&#39;s his dig level?What&#39;s his dig level?The Happy Hospitalisthttp://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-82428432062724177682009-11-30T15:35:28.729-06:002009-11-30T15:35:28.729-06:00#1 Dino-
The potassium was treated, so the T-wave...#1 Dino-<br /><br />The potassium was treated, so the T-waves you were expecting resolved. (Realize that with VERY high potassiums - typically greater than 7.5 - the QRS and T wave also widen...) That&#39;s why you don&#39;t see the peaked T waves on this tracing, but the potassium value was confirmed...DrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-47331277636710934602009-11-30T14:40:59.085-06:002009-11-30T14:40:59.085-06:00&quot;Was the initial blood specimen hemolyzed?&qu...&quot;Was the initial blood specimen hemolyzed?&quot;<br /><br />I don&#39;t see the tall peaked T-waves associated with hyperkalemia*. Was the initial potassium level spuriously high from a hemolyzed specimen, and therefore not the actual cause of his condition?<br /><br />*That&#39;s about all I know about EKGs and electrolytes.#1 Dinosaurhttp://www.blogger.com/profile/01357845504444464397noreply@blogger.com